Pharmaceutical representatives and doctors in the Philippines maintain a
mutually beneficial relationship. The representatives utilize Filipino cultural
norms to get doctors to prescribe the drugs they promote. One core social value
in the Philippines is that when someone receives a gift, he or she has a
“debt of gratitude” that must be paid back. Capitalizing on this
principle, representatives will give gifts to doctors, run their errands, pay
for dinner and essentially befriend doctors in order to promote prescription of
their products. Doctors in the Philippines view relationships with medical
representatives as essential to good medicine due to the “help”
they receive as a result. Doctors recognize the economic interests of
pharmaceutical companies, but still positively value the relationship because
the representatives become viewed as friends. In order for there to be an
increase in non-commercial drug information, educational campaigns backed by
government regulations would be necessary. The ban on samples under the infant
formula code is one example of how regulation can improve the ethical promotion
of drugs. Similar guidelines would help the Filipino doctors overcome cultural
tendencies and refocus prescribing habits on public health concerns rather than
social norms.